CN112367937A - Bone plating system - Google Patents

Abstract

In one aspect, a bone plate system includes a bone plate having a plurality of elongated through openings. The bone plating system includes a plurality of bone screws and a plurality of slides located in elongated through openings of the bone plate, the plurality of slides receiving the bone screws. The bone plating system includes at least one resilient member configured to apply a biasing force to each of the slides to urge the slide toward one end portion of the respective through opening. Further, the bone plating system includes at least one actuator having an interference position in which the actuator prevents displacement of the slide toward the one end portion of the through opening and a clearance position in which the actuator allows the at least one resilient member to urge the slide and the bone screw received therein toward the one end portion of the through opening.

Description

Bone plating system

Cross Reference to Related Applications

This application claims the benefit of U.S. provisional application No.62/692,464 filed on 29.6.2018, which is hereby incorporated by reference in its entirety.

Technical Field

The present disclosure relates to bone plating systems that are secured to bones, and more particularly to bone plating systems for securing to bones and compressing the bones together to promote fusion of the bones.

Background

Bone plating systems are known for stabilizing bones. As used herein, the term "bone" refers to the entire bone or a portion of the bone. The bone stabilized by the bone plating system may be, for example, a portion of a single bone, such as a fractured clavicle or a separated vertebra. One application of the bone plating system is to secure two or more vertebrae together with an intervertebral implant positioned between the vertebrae. Another application of the bone plating system is to fuse portions of bone that have been separated by fracture or cutting. For example, the bone plating system may be used to promote fusion of portions of a clavicle, scapula, foot, or other fractured bone of a limb.

Disclosure of Invention

According to one aspect of the present disclosure, a bone plating system is provided that includes a bone plate having a plurality of elongated through openings. Each elongated through opening has a pair of end portions that span each other across the through opening. The bone plating system includes a plurality of bone screws, each having a head portion and a shank portion, the shank portion configured to be driven into bone. The bone plating system includes a plurality of slides in elongated through openings of the bone plate. Each of the slides has a through hole configured to receive a head portion of one of the bone anchors. The slide and the portion of the bone screw head received therein are displaceable relative to the bone plate within the elongated through opening. The bone plating system includes at least one resilient member configured to apply a biasing force to each of the slides to urge the slide toward one end portion of the respective through opening. Furthermore, the bone plating system comprises at least one actuator having an interference position in which the actuator prevents displacement of the slide towards one end portion of the respective through opening. The at least one actuator also has a clearance position in which the actuator allows the at least one resilient member to urge the slide and the bone screw received therein toward one end portion of the through opening. In this manner, the bone plating system may be secured to the bone and the at least one actuator is moved from the interference position to the clearance position to cause the at least one resilient member to urge the slide and bone screw along the elongated through opening and compress the bone together. In addition, the bone plate is made of a rigid material, such as titanium, to resist post-operative loads from the bone and to keep the bone compressed together.

The present disclosure also provides a bone plating system for fixing a pair of bones. The bone plating system includes a bone plate, an elongated through opening of the bone plate, and a pair of bone screws for securing the bone plate to the bone. The bone plating system further includes a pair of slides in the elongated through openings, each slide having a through hole for receiving a bone screw, and at least one actuator configured to be clamped between the slide and the bone plate. Further, the bone plating system includes at least one resilient member configured to apply a biasing force to the slide to urge the slide against the at least one actuator and cause the slide to clamp the at least one actuator between the slide and the bone plate. At least one actuator is removable from being clamped between the sled and the bone plate such that a biasing force urges each sled and the bone screw therein toward the other sled and the bone screw to compress the bones together. Thus, the bone plate system provides a fixation assembly of at least one actuator clamped between the slide and the bone plate, which improves the ease of handling of the bone plate system during installation. Further, the at least one resilient member provides an easy to use method for applying a biasing force against the bone by removing the at least one actuator from the bone plate.

According to another aspect of the present disclosure, a method for compressing a pair of bones is provided. The method includes positioning the bone plate against the bone and driving a shank of the bone screw into a through hole of a slide located in an elongated through opening of the bone plate and into engagement with the bone. The method includes removing the at least one actuator from the bone plate and allowing the at least one resilient member to urge the sled and a portion of the bone screw head in the sled toward each other along the elongated through opening of the bone plate and compress the bone together. In this manner, the method may be used to quickly fix the bone plate to the bone by driving the bone screws into the through holes of the slide, and to compress the bone by removing the at least one actuator from the bone plate.

Drawings

FIG. 1 is a perspective view of a bone plating system including a bone plate, a slider assembly in an elongated through opening of the bone plate, a bone screw in the slider assembly, and a removable spacer retaining the slider assembly at one end of the through opening;

FIG. 2 is a cross-sectional view taken along line 2-2 of FIG. 1, showing the body of the spacer spacing the slider of the slider assembly from the wall of the bone plate;

FIG. 3 is a top plan view of the bone plating system of FIG. 1 secured to bones with a gap therebetween;

FIG. 4 is a cross-sectional view taken along line 4-4 of FIG. 2, showing the elastic wire of the slider assembly in a loaded configuration, clamping the spacer between the slider and the bone plate;

FIG. 5 is a view similar to FIG. 3, showing the spacer removed and the elastic wire having pushed the sled and the bone screw received therein toward the opposite end of the elongated through opening, which compresses the bone;

FIG. 6 is a cross-sectional view similar to FIG. 4, showing the elastic wire in an unloaded configuration after the spacer has been removed and the elastic wire has displaced the slider toward the end of the elongated through opening;

FIG. 7 is a stress-strain plot of the properties of superelastic Nitinol;

FIG. 8 is an exploded view of the bone plating system of FIG. 1, showing the bone plate, slide and elastic wire;

FIG. 9A is a cross-sectional view of the bone plate taken at one of the through openings of the bone plate;

FIG. 9B is a cross-sectional view taken alongline 9B-9B of FIG. 9A, showing the slide in the through opening of the bone plate and the bone anchor received in the through hole of the slide;

FIG. 10 is a cross-sectional view taken along line 10-10 in FIG. 9A, showing the through hole of the side wall of the bone plate receiving the end of the elastic wire;

FIG. 11 is a perspective view of one of the slides of FIG. 8, showing the channel of the slide that receives the elastic strand;

FIG. 12 is a side elevational view of the slider of FIG. 11 showing the channel extending through the slider;

FIG. 13 is an end elevational view of the slider of FIG. 11, showing an enlarged portion of one of the channels of the slider accommodating movement of the portion of the elastic wire extending through the channel;

FIG. 14 is a cross-sectional view of the slider taken along line 14-14 in FIG. 13, showing the channel of the slider having an angled surface and a curved surface for supporting the elastic wire in its loaded configuration;

FIG. 15 is a cross-sectional view similar to FIG. 14, showing the elastic strands extended in the channel of the slider and in their loaded configuration, with portions of the elastic strands extending along the angled and curved surfaces of the slider channel;

FIG. 16 is a cross-sectional view similar to FIG. 15, showing the elastic strand in an unloaded configuration, wherein a portion of the elastic strand has been pivoted to a straight configuration, wherein the portion is spaced from the inclined and curved surfaces of the channel;

FIG. 17 is a side elevational view of one of the spacers of the bone plating system of FIG. 1, showing the recess of the spacer receiving the slide on one side of the spacer and the wall of the bone plate on the other side of the spacer;

FIG. 18 is a cross-sectional view of one of the bone screws of the bone plating system of FIG. 1;

FIG. 19 is a perspective view of an instrument for removing the spacer of the bone plating system of FIG. 1;

FIG. 20 is a cross-sectional view taken along line 20-20 of FIG. 19, showing the inner shaft of the instrument displaceable relative to the outer shaft of the instrument;

FIG. 21A is a cross-sectional view taken generally alongline 21A-21A in FIG. 20, showing the resilient fingers engaging the inner shaft of the underside of the head of the spacer of the bone plating system;

FIG. 21B is a cross-sectional view of the instrument and bone plating system of FIG. 21A, taken generally perpendicular to the cross-section of FIG. 21A, showing the inner shaft engaged with the head of the spacer and the outer sleeve adjacent the upper surface of the bone plate;

FIG. 21C is a cross-sectional view similar to FIG. 21B, showing the inner shaft displaced proximally relative to the outer sleeve, the inner shaft removing the spacer from the gap between the slide and the wall of the bone plate;

FIG. 21D is a cross-sectional view similar to FIG. 21B showing the inner shaft engaged with the head of the second spacer while the inner shaft contains the first spacer from a previous spacer removal procedure;

FIG. 21E is a cross-sectional view similar to FIG. 21D, showing the inner shaft displaced proximally relative to the outer sleeve, the inner shaft removing the second spacer from the gap between the slide and the wall of the bone plate;

FIG. 22 is a perspective view of another bone plating system having a slider assembly that receives two bone screws;

FIG. 23 is a top plan view of the two bone screw receiving slider assemblies of FIG. 22 including the slider and the elastic wire having end portions extending outwardly from the sides of the slider;

FIG. 24 is a side elevational view of the slider assembly of FIG. 23, showing an end portion of the wire extending outwardly from the channel of the slider;

FIG. 25 is a front elevational view of the slider of FIG. 23 showing the curvature of the slider;

FIG. 26 is a cross-sectional view taken generally along the line 26-26 in FIG. 24, showing the line in the loaded configuration and extending along the angled and curved support surfaces of the slider;

FIG. 27 is a cross-sectional view taken along line 27-27 of FIG. 23, illustrating the angle between portions of one of the channels of the slide;

FIG. 28 is a top plan view of an elastic strand extending through the channel of FIG. 27, showing the strand in a loaded configuration;

FIG. 29 is a front elevational view of the line of FIG. 28, showing the line in the loaded configuration;

FIG. 30 is a side elevational view of the line of FIG. 28 in the loaded configuration;

FIG. 31 is a perspective view of a bone plate system having a dog bone shaped bone plate;

fig. 32 is a perspective view of another bone plate having a through opening for receiving a slider and an opening in a side wall of the bone plate for receiving an elastic wire that urges the slider in a predetermined direction within the through hole;

fig. 33 is an end elevational view of the bone plate of fig. 32, showing the bone plate at a reduced thickness intermediate the bone plate;

fig. 34 is a cross-sectional view of a portion of the bone plate of fig. 32, the cross-sectional view being taken along line 34-34 in fig. 32, showing an aperture in one of the side walls of the bone plate for receiving the elastic wire of the slider received in the associated through opening; and

fig. 35 is a cross-sectional view of a portion of the bone plate of fig. 32, the cross-sectional view being taken along line 35-35 in fig. 32, illustrating the geometry of the apertures of the side walls of the bone plate.

Detailed Description

Referring to fig. 1, abone plating system 10 is provided, thebone plating system 10 including abone plate 12 having one or more throughopenings 14 therein that receive one ormore slide assemblies 16. Theslider assemblies 16 each include aslider 18 and one or more resilient members, such aswires 20, 22 (see fig. 4). Thewires 20, 22 have a loaded configuration wherein thewires 20, 22 apply a biasing force to theslides 18 that urges each of theslides 18 toward one end portion 64 (see fig. 2) of the respective throughopening 14. Thebone plating system 10 further includes at least one actuator, such asspacer 36, that resists movement of theslide 18 toward oneend portion 64 of the respective throughopening 14 and maintains thewires 20, 22 in the loaded configuration. Because thespacers 36 maintain thewires 20, 22 in the loaded configuration, thewires 20, 22 have a preload that can be released by removing thespacers 36 from the throughopenings 14. Theslide 18 includesslides 18A, 18B for securing to a first bone 86 (see fig. 3) and slides 18C, 18D for securing to asecond bone 84. The slidingmembers 18 each include one or more through-holes 32 that receive bone anchors, such as bone screws 30.

To install thebone plating system 10, thebone plate 12 is positioned against thebones 84, 86, and thebone screw 30 is driven into the through-hole 32 of theslide 18 and into thebones 84, 86 until thehead portion 34 of thebone screw 30 is seated in the through-hole 32 of theslide 18, as shown in fig. 1. The user then operates at least one actuator to cause thebone plating system 10 to compress thebones 84, 86. In one embodiment, the user operates the at least one actuator by removingspacer 36 frombone plate 12 generally in direction 38. Once thespacer 36 is removed, thewires 20, 22 of thetraveler assembly 16 can be unloaded and push therunners 18A, 18B and the bone screws 30 in therunners 18A, 18B in thedirection 24 and therunners 18C, 18D and the bone screws 30 in therunners 18C, 18D in thedirection 26. This compresses thebones 84, 86 together, as shown in fig. 5. Compressing thebones 84, 86 helps fuse thebones 84, 86 together, or in another embodiment, fuses thebones 84, 86 together with a device positioned between thebones 84, 86, such as an intervertebral implant positioned between two vertebrae.

Referring to FIG. 2, thespacers 36 each include ahead 40 and abody 42. Thehead 40 is configured to be engaged by an actuator removal instrument, such as a spacer removal instrument 50 (see fig. 19). Referring to slide 18D, thebody 42 ofspacer 36 is sized to extend into one of the throughopenings 14 and separate theslide 18D from the transversely extendingwall 52 of thebone plate 12. More specifically,body 42 includesflats 54, 56, with flat 54 engaging aflat surface 58 ofslider 18D and flat 56 engaging aflat surface 60 ofwall 52. With thespacer 36 connected to thebone plate 12, the presence of thespacer body 42 in the throughopening 14 retains theslide 18D at oneend portion 62 of the throughhole 32 and maintains thewires 20, 22 in the loaded configuration (see fig. 4). The biasing force provided by thewires 20, 22 clamps thebody 42 of thespacer 36 between theslide 18D and thewall 52 of thebone plate 12. By removingspacer 36 frombone plate 12,wires 20, 22 may displaceslide 18D indirection 24 toward opposingend portions 64 of throughopening 14. Theslides 18A, 18B, 18C operate in a similar manner as discussed with respect to slide 18D.

Bone plate 12,slide 18, andspacer 36 are made of a rigid material, meaning that they do not deform during normal installation and post-operative use ofbone plate system 10. In one example, thebone plate 12,slide 18, andspacer 36 are made of a metallic material, such as titanium. The rigidity of thespacer 36 prevents thewires 20, 22 from being able to shift to their unloaded configuration when thespacer 36 is present in the throughopening 14.

Thewires 20, 22 are made of an elastic material, which means that thewires 20, 22 are deformable and are able to spring back or spring back after bending. Other elastic members may be used, such as elastic members that spring or spring back to shape after being stretched or compressed. Together, thewires 20, 22 apply a predetermined biasing force to therespective slide 18, such as in the range of about five pounds to about fifteen pounds, such as about ten pounds of force. Thewires 20, 22 of theslide 18 also overlap with the other levels of thebone plate 12 so that, for fourslides 18, theslide 18 and bone screws 30 in theslide 18 compress thebones 84, 86 with a compression force of forty pounds.

In one example, thewires 20, 22 are made of a superelastic material. The superelastic material may be a metallic material, such as superelastic nitinol. By way of example, thewires 20, 22 may be made of superelastic nitinol, and may each have a diameter of 0.028 inches. Thebone plate system 10 utilizing thesewires 20, 22 may provide a compressive force of 63 pounds. The biasing force of thewires 20, 22 increases rapidly with a relatively small increase in diameter. For example, abone plate system 10 utilizingsuperelastic nitinol wires 20, 22 having a diameter of 0.035 inches per wire may provide a compressive force of 141 pounds.

As used herein, the terms loaded configuration and unloaded configuration with reference tolines 20, 22 are relative terms, whereinlines 20, 22 are loaded or deformed more in the loaded configuration than in the unloaded configuration. Thus, when thewires 20, 22 are described as being in an unloaded configuration, rather than having to completely unload thewires 20, 22, thewires 20, 22 are less loaded or deformed than when the wires are in the loaded configuration.

With respect to fig. 2,spacer 36 is configured to facilitate removal ofspacer 36 byspacer removal instrument 50. In one form,spacer 36 includes ashoulder 70 that rests on anupper surface 72 ofbone plate 12. Theshoulder 70 positions anunderside surface 74 of the head 40 adistance 76 above the bone plateupper surface 72.Distance 76 forms agap 78 of thebone plate 12/spacer 36 assembly into which a portion ofinstrument 50 may fit and engageunderside surface 74 ofhead 40.Bone plate 12 has alower surface 80 oppositeupper surface 72, withlower surface 80 being adapted to be positioned againstbones 84, 86. Thelower surface 80 may have a concave curvature that is complementary to the outer surface of thebones 84, 86.

Referring to fig. 3,bone plate 12 has been positioned againstbones 84, 86 separated by asmall gap 88. Thebone screw 30 has been driven into the throughhole 32 of theslide 18, and in the embodiment of fig. 3, thebone plate 12 has alongitudinal axis 90 and all of theslides 18A, 18B, 18C, 18D are aligned along the longitudinal axis. This provides thebone plate 12 with a small footprint on thebones 84, 86 and is well suited for narrow bones such as the bones of the clavicle, foot or other limb.

Referring to fig. 4,spacer 36 is connected tobone plate 12 and holdsslide 18 atend portion 62 of throughopening 14. Because theslide 18 is retained at theend portion 62 of the throughopening 14, theslide 18 maintains thewires 20, 22 in the loaded configuration. Thewires 20, 22 extend throughchannels 23, 25 (see fig. 8) of theslider 18 and have a curved configuration around thewalls 100, 102 of theslider 18. Thewires 20, 22 each have anintermediate portion 107 fixed to theslide 18. In one embodiment, theintermediate portion 107 is secured to theslide 18, for example by forming a recess in an upper surface 109 (see fig. 11) of anupper wall 111 of theslide 18 that deforms theupper wall 111 into engagement with theintermediate portion 107.

Referring to fig. 4, thewires 20, 22 includeend portions 104, 106 that extend out of thechannels 23, 25 and are received inwire receiving portions 110, 112 of thebone plate 12. Thewire receiving portions 110, 112 include pairs ofapertures 114, 116 that receive thewire end portions 104, 106. More specifically, theend portions 104, 106 of thewire 20 extend out of thechannel 23 and into theholes 114, 116 of thebone plate 12. Likewise, theend portions 104, 106 of thewire 22 extend out of thechannel 25 and into theholes 114, 116 of thebone plate 12. Thewires 20, 22 support theslide 18 in the throughopening 14. Thewires 20, 22 are made of a material sufficient to provide pull-through resistance to theslide 18 and have a diameter sufficient to provide pull-through resistance to theslide 18 such that theslide 18 and the bone screws 30 therein remain within the throughopenings 14 of thebone plate 12 despite the application of loads to the bone screws 30 by thebones 84, 86.

Referring to fig. 5,spacer 36 has been removed frombone plate 12, which allowswires 20, 22 to unload by straightening. Unloading thelines 20, 22 converts the preload or stored potential energy in thelines 20, 22 into a biasing force that displaces theslides 18A, 18B in thedirection 24 and displaces theslides 18C, 18D in thedirection 26. Displacement of theslide 18 in thedirections 24, 26 pushes thebones 84, 86 together and removes thegap 88 between thebones 84, 86. In one embodiment, thewires 20, 24 are capable of displacing theslider 18 from anend portion 62 of the throughopening 14 to anopposite end portion 64 of the throughopening 14. Furthermore, thewires 20, 24 may push theslider 18 along the throughopening 14 less than the entire distance, depending on the patient anatomy. If theslide 18 is spaced from the transversely extending wall of thebone plate 12 at theend portion 64 of the throughopening 14, thewires 20, 22 will bend and will continue to apply a biasing force to theslide 18.

Referring to fig. 6, thewires 20, 22 are shown in an unloaded configuration after thespacer 36 has been removed and thewires 20, 22 have pushed theslide 18 to theend portion 64 of the throughopening 14. In the unloaded configuration, thewires 20, 22 are substantially straight with theend portions 104, 106 being substantially coaxial with theintermediate portion 107. However, in other embodiments, thewires 20, 22 may still bend in the unloaded configuration, for example if the patient's bone prevents theslider 18 from being displaced the full distance across the throughopening 14. By comparing fig. 4 and 6, when thewires 20, 22 are displaced from the loaded configuration to the unloaded configuration, theend portions 104, 106 swing or pivot from an orientation extending transversely relative to one another to a coaxial orientation relative to one another.

Referring to fig. 7, thewires 20, 22 may be made of a superelastic material, such as nitinol, having a stress-strain curve 150. Thenitinol wires 20, 22 have a first characteristic (e.g., spring constant) when thewires 20, 22 bias theslide 18 in thedirections 24, 26 (see fig. 2) toward theend portion 64 of the throughopening 14, such as after thespacer 36 is removed from thebone plate 12. However, when theslider 18 is displaced in thedirection 27, 29 towards theend portion 62 of the throughopening 14, thenitinol wires 20, 22 have a second characteristic (e.g. spring constant) different from the first characteristic, for example if thebones 84, 86 are pushed apart due to patient movement. Referring to fig. 1, the different first and second characteristics are such that thewires 20, 22 provide greater resistance to movement of theslides 18A, 18B in thedirection 29 and movement of theslides 18C, 18D in thedirection 27 than the force that thewires 20, 22 exert against theslide 18 to displace theslides 18A, 18B in thedirection 24 and theslides 18C, 18D in thedirection 26. The higher resistance to displacement of theslider 18 in thedirections 27, 29 causes thewires 20, 22 to act as a one-way slide control mechanism that effectively limits sliding movement of theslider 18 in thedirections 24, 26 while inhibiting sliding movement of theslider 18 in thedirections 29, 27.

The different properties of thenitinol wires 20, 22 may be due to stress-induced formation of some martensite in the superelastic nitinol of thewires 20, 22 at temperatures above the normal temperature for martensite formation. Because martensite is formed above its normal formation temperature, when the stress is relieved, the martensite immediately reverts to the undeformed austenite. Austenite is stronger than martensite and resists bending of thenitinol wires 20, 22 back to their loaded configuration more strongly.

For example, if thewires 20, 22 begin at position a in thegraph 150 when thebone plating system 10 is secured to thebones 84, 86, removing thespacer 36 allows thewires 20, 22 to displace theslide 18 toward theend portion 64 of the throughopening 14. Movement of theslider 18 in the unloading direction relieves the stress in thewires 20, 22 and moves the stress and strain of thewires 20, 22 towards position B. As theslide 18 further compresses thebones 84, 86 together, the stress and strain of thewires 20, 22 move to position C in the stress-strain graph 150. However, if post-operative patient motion applies a load on the associatedbone screw 30 in thedirection 27, thewires 20, 22 of theslide 18D resist the motion and the stress and strain within thewires 20, 22 jumps to position D in the stress-strain graph 150. A jump to the upper band of the stress-strain plot 150 indicates that the stress in the material is too high, which translates into greater resistance to bending of thewires 20, 22 back to their loaded configuration.

Referring to fig. 8, theslide 18 and thewires 20, 22 of each slide are shown prior to assembly with thebone plate 12. During assembly, theslider 18 is inserted in thedirection 160 into the throughopening 14. Theslides 18 are positioned in their unloaded position, i.e. at theend portions 64 of the throughopenings 14.

Next, thewires 20, 22 are provided in a straight, unloaded configuration. Theend portions 104 of thewires 20, 22 are advanced in thedirection 162 through theaperture 116 of thebone plate 12, through thechannels 23, 25 of theslide 18, and into the through-goingapertures 114 in the opposite side of thebone plate 12. Thereby positioning thewires 20, 22 such that theintermediate portion 107 of eachwire 20, 22 extends through therespective channel 23, 25, theend portion 104 of eachwire 20 is received in one of the throughapertures 114, and theend portion 106 of eachwire 20, 22 is received in one of the throughapertures 116.

Then, theslider 18 is displaced in thepreloading direction 164, 166 towards its loading position, i.e. towards the end portion 62 (see fig. 2) of the through-opening 14. Displacement of theslide 18 in thepreload directions 164, 166 loads or bends thewires 20, 22 and creates agap 64A (see fig. 2) between theslide 18 and the transversely extendingwalls 52, 53 of thebone plate 12. The displacement of theslide 18 in thepreload directions 164, 166 may be performed by a technician using a tool or an automated machine as some examples.

Referring to fig. 8, to attachspacer 36 tobone plate 12,spacer 36 is advanced generally indirection 160 intogap 64A betweenslide 18 and the adjacent bone plate laterally extendingwalls 52, 53, whileslide 18 is held in its loaded position by a technician or automated machine. Once thespacer 36 is positioned in thegap 64A, theslides 18 are released and thewires 20, 22 of each slide 18 push theslide 18 against thespacer 36, which clamps thespacer 36 between theslide 18 and the laterally extendingbone plate walls 52, 53. The process of displacing theslides 18 to the loaded position and attaching thespacer 36 to thebone plate 12 may be performed on all of theslides 18 at once, or may be performed on less than all of the slides 18 (e.g., one or more) at once.

With respect to fig. 9A,bone plate 12 includes anend wall 170 opposite transversely extendingwall 52 andside walls 172, 174 through whichapertures 114, 116 extend. Theapertures 114, 116 have a constantly changing profile to accommodate movement of theend portions 104, 106 of thewires 20, 22. Furthermore, each through opening 14 has alongitudinal axis 175 extending between theend portions 62, 64 of the throughopening 14. Although the following discussion refers to the throughbore 114, it should be understood that the throughbore 116 is a mirror image of the throughbore 114, such that the following discussion also applies to the throughbore 116, thewire end portion 106, and thesidewall 174.

The through-opening 114 includes anarrow portion 180 having adistance 182 thereacross and anenlarged portion 184 having adistance 186 thereacross greater than thedistance 182.Enlarged portion 184 provides clearance forend portion 104 ofwire 20 to move from its tilted or transverse orientation whenwire 20, 22 is in the loaded configuration (see fig. 4) to a parallel or coaxial orientation whenwire 20, 22 is in its unloaded configuration (see fig. 6).

Theside wall 172 also includes features that support theend portions 104 of thewires 20, 22 while minimizing the stress applied to thewires 20, 22. For example, thesidewall 172 includes anangled surface 190 that extends at anacute angle 192 relative to theaxis 120 extending transversely through theapertures 114, 116.

Referring to fig. 9B and 11, theslide 18 has a generally rectangular configuration and the throughopening 14 has a generally rectangular configuration that is longer than theslide 18 to allow theslide 18 and the bone screws 30 therein to slide longitudinally along thebone plate 12 within the throughopening 14. Theslider 18 includes abody 220 havinglateral sides 222, 224. Thesides 222, 224 includeflat surfaces 226, 227, theflat surfaces 226, 227 for facing theflat surfaces 208, 210 of the bone plate sidewalls 172, 174, as shown in fig. 9B. Thechannels 23, 25 of theslide 18 includeopenings 230, 232 to thesides 222, 226 (see fig. 14). The opposingplanar surfaces 208, 226 and 210, 227 of theslide 18 andbone plate 12 resist rotation of theslide 18 within the throughopening 14.

With respect to fig. 10, theside walls 172, 174 of thebone plate 12 includewall portions 200, 202 above and below thewires 20, 22 as the wires extend through theapertures 114, 116. Thewires 20, 22 support theslide 18 within the through opening 14 of thebone plate 12, preventing theslide 18 from moving out of the plane of thebone plate 12 indirections 204, 205. Thewires 20, 22 are made of a material having sufficient shear strength and their appropriate diameter has sufficient shear strength to resist the load applied to theslide 18 by the bone screws 30.

Referring to fig. 12, thelateral sides 222, 224 of theslider 18 extend longitudinally between thefront side 240 and therear side 242. Further, thechannels 23, 25 extend through theslide 18 and includeangled surfaces 298 androunded surfaces 316 leading into thechannels 23, 25 from thesides 222, 224.

Turning to fig. 13, thechannel 25 includesenlarged side portions 254, 256, theenlarged side portions 254, 256 for receiving thewire 22 and allowing theend portions 104, 106 to pivot or swing in space as thewire 22 straightens toward its undeflected configuration. Referring to fig. 14, the dimensions of thechannel 23 of theslide 18 vary as thechannel 23 extends laterally across theslide 18 to provide support to thewire 20 when thewire 20 is in its deflected configuration and to provide clearance for thewire 20 when thewire 20 is moved from the deflected configuration to the undeflected configuration. Thechannel 23 includesenlarged side portions 232, 230 and amiddle portion 270. Thechannel 23 has afirst distance 272 thereacross at theenlarged side portion 232, asecond distance 274 thereacross intermediate theenlarged portion 232 and theintermediate portion 270, and athird distance 276 at theintermediate portion 270.Distance 272 is greater thandistance 274 anddistance 274 is greater thandistance 276. Similar dimensions exist at theenlarged side portions 230.

Theslide 18 includes awall 280 that abuts against or is very close to a laterally extending wall of thebone plate 12, such as thewalls 52, 170, when theslide 18 is in its loaded position. Theslider 18 also includes awall 100 extending around the through-hole 32.Wall 280 may extend transversely across the slider generally straight, whilewall 100 includes angledsurface 290 atpassage 23, roundedcorner 292,intermediate support surface 294, roundedcorner 296, andangled surface 298. Theangled surfaces 290, 298 each extend at anangle 300 relative to atransverse axis 302 extending straight through thechannel 23.

Similarly, thechannel 25 includesenlarged side portions 254, 256 and awall 102 extending generally transversely across theslider 18. Theslider 18 also includes awall 102 having arounded surface 312, anintermediate support surface 314, and arounded surface 316. The dimensions ofchannel 35 vary aschannel 25 extends throughslide 18, including havingdimension 317 atenlarged side portion 254 with asmaller distance 318 acrosschannel 25 atmiddle portion 320.

Fig. 15 shows thewires 20, 22 in their deflected or loaded configuration, wherein theend portions 104, 106 of thewires 20, 22 extend outwardly from thelateral sides 222, 224 of theslide 18 for connection to thebone plate 12. In the loaded configuration, thewires 20, 22 include outerintermediate portions 330, 332, the outerintermediate portions 330, 332 extending along and supported by theangled surfaces 290, 298 and therounded surfaces 312, 316. Thewires 20, 22 also includeintermediate portions 107, 340 supported by intermediate support surfaces 294, 314, respectively. In addition, therounded corners 292, 296 androunded surfaces 312, 316 provide support without sharp corners, which reduces stress in thewires 20, 22. Eachwire 20, 22 generally has abend 295, thebend 295 being complementary in shape to thesurfaces 292, 294, 296 or thesurfaces 312, 314, 316. Thewalls 100, 102 of theslider 18 may thus be configured to complement the desired amount ofcurvature 295 of thewires 20, 22 while limiting the stress applied to thewires 20, 22 supported by thewalls 100, 102.

Withwires 20, 22 in the loaded configuration,wires 20, 22 each extend at anangle 352 relative totransverse axis 302 ofchannels 23, 25. Theangles 352 may be the same or different, depending on the particular application. Forwire 20, outerintermediate portion 330 is separated fromwall 280 by adistance 342 by agap 350 that increases in size aswire 20 extends away fromintermediate support surface 294, as shown in fig. 15. Oncespacer 36 has been removed frombone plate 12,gap 350 provides clearance for movement of outerintermediate portion 330 andwire 20 may straighten. Thewire 22 also has a gap from thewall 100 that varies as thewire 22 extends laterally outward.

With respect to fig. 16, thewires 20, 22 are shown in an undeflected configuration, such as after thespacer 36 has been removed from thebone plate 12. The outerintermediate portions 330, 332 of thewires 20, 22 are pivoted in thedirection 360 into contact with thewalls 100, 280. This results in thegap 362 separating the outerintermediate portions 330, 332 of thewire 20 from theangled surfaces 290, 298 of thewall 100 of theslider 18. Thewire 20 is spaced from thewall 100 by adistance 364 that increases as thewire 20 extends laterally away from theintermediate support surface 294. Likewise, the outerintermediate portions 330, 332 of thewire 22 are spaced from thecurved surfaces 312, 316 of thewall 102 by agap 368.

With respect to fig. 2 and 17, whenspacer 36 is attached tobone plate 12, eachshoulder 70 ofspacer 36 defines anotch 380 that receives acorner 382 ofbone plate 12. Theshoulder 70 has alower surface 384 that rests on theupper surface 72 of thebone plate 12. Thehead 40 has a taperedsurface 386, thetapered surface 386 extending downwardly from a roundedupper surface 388 of thehead 40 to a cylindrical radiallyouter surface 390.Surface 384 contactsupper surface 72 ofbone plate 12 andslide 18 and resists tilting or other movement ofspacer 36 that may result inspacer 36 being accidentally removed frombone plate 12, such as during handling ofbone plate 12 prior to placement ofbone plate 12 at a surgical site. In addition,flats 54, 56 ofspacer 36 are perpendicular to the biasing and reactive forces exerted onspacer 36 byslide 18 andbone plate 12, which facilitates secure clamping ofspacer 36 tobone plate 12.

Tapered surface 386 is configured to camresilient fingers 400 of spacer removal instrument 50 (see fig. 19) radially outward asinstrument 40 is connected to spacer 36 andresilient fingers 400 are advanced alonghead 40 indirection 392. Once theresilient fingers 400 have advanced past thecylindrical surface 390, theresilient fingers 400 snap under theunderside surface 74 of thehead 40 of thespacer 36. With theresilient fingers 400 located below theunderside surface 74 of thehead 40, the user may pull theinstrument 50 upward indirection 396 and withdraw thebody 42 from between theslide 18 and thebone plate 12. Movement ofinstrument 40 indirection 396 causesresilient fingers 400 to engageunderside surface 74 ofhead 40 and pullspacer 36 out ofgap 64A betweenslide 18 andbone plate 12.

Thebody 42 of thespacer 36 includes alower body portion 393 having athickness 395 measured between theflat portions 54, 56. Thethickness 395, in combination with the geometry of theslide 18 andbone plate 12, is selected to maintain thewires 20, 22 in the loaded configuration with the greatest desired deformation in thewires 20, 22.

Referring to fig. 18, the bone screws 30 each include ahead portion 34 and ashank portion 404. Theshaft portion 404 includesthreads 406 for driving into bone. In one embodiment, theshank portion 404 is configured to be self-tapping. Thehead portion 34 includes a rotational drive structure, such as asocket 406, which receives a screwdriver, such as a hex head screwdriver. Thehead portion 34 also includes a curvedlower surface 408 for engaging a seating surface 410 (see fig. 9B) of theslider 18.

Referring to fig. 19,spacer removal instrument 50 includes ahandle assembly 420 and ashaft assembly 422.Shaft assembly 422 includes adistal end portion 424 configured to engage one of theheads 40 ofspacer 36 and aproximal end portion 425 connected to handleassembly 420. Thehandle assembly 420 includes a fixedgrip 428 and ahandle 426 pivotally connected to the fixedgrip 428 by apin 429.

Referring to fig. 20,shaft assembly 422 includes anouter sleeve 430 mounted to a fixedgrip 428 and aninner shaft 432 connected to handle 426. Theinner shaft 432 includes arim 440 having one or moreresilient fingers 400 mounted thereon. Theresilient fingers 400 are mounted to theinner shaft 432 with pins that extend through openings 441 (see fig. 21A) of theresilient fingers 411. In another embodiment, theinner shaft 432 and one or moreresilient fingers 400 have a unitary structure rather than being assembled.Inner shaft 432 also includes abushing 442, whichbushing 442 is used to holdspacers 36 in line withinbushing 442 asspacers 36 are removed one by one frombone plate 12. In another embodiment, thegrip 428 may be movable while thehandle 426 may be fixed, or both thegrip 428 and thehandle 426 may be movable to operate theinstrument 50.

Referring to fig. 21A-21C, a method of removing aspacer 814 from a bone plate 802 (see fig. 31) of abone plating system 800 using theinstrument 50 is provided. First, the user grasps theinstrument 50 such that theopening 446 of theinner shaft 432 is adjacent thehead 815 of thespacer 814. The user advancesinstrument 50 indirection 405 towardbone plate 802 untilhead 815 enters opening 446 andresilient finger 400 snaps underhead 815 ofspacer 814. The user then pivots thegrip 426 in direction 450 (see fig. 20) while pressing theinstrument 50 against thebone plate 802. Pivoting of thegrip 426 causes theinner shaft 432 to displace indirection 447 relative to theouter sleeve 430 and causes theresilient finger 400 to engage the underside of thehead 815. Wheninner shaft 432 is displaced indirection 447,rim 449 ofouter sleeve 430contacts bone plate 802 and one of theslides 808 located in the bone plate. As shown in fig. 21B and 21C, auser moving handle 426 toward fixedgrip 428 causesinner shaft 432 to pull spacer 814 outward frombone plate 802 indirection 447.

Once thespacer 814 has been removed from thebone plate 802, the user releases thehandle 426, and thehandle 426 may be biased back to its original position by the spring of theinstrument 50. Referring to fig. 21D, the user then positions theinstrument 50 at thesecond spacer 814. While thefirst spacer 814 is held within thecannula 442 by theresilient fingers 400, the user may simply press theinstrument 50 onto thesecond spacer 814 indirection 405, which causes thesecond spacer 814 to displace thefirst spacer 814 further into thecannula 442 and beyond theresilient fingers 400, as shown in fig. 21D. Theinstrument 50 is pressed indirection 405 until theresilient finger 400 snaps under thehead 815 of the second spacer. Next, the user pivots thehandle 426 toward the fixedgrip 428, which causes theinner shaft 432 to displace in thedirection 447, the outer sleeve engages thebone plate 802/slide 808, and theinner shaft 432/resilient finger 400 pulls thesecond spacer 814 out of thebone plate 802, as shown in fig. 21D and 21E.

Referring to fig. 22, abone plating system 600 is provided, thebone plating system 600 including abone plate 602 and aslider assembly 604, the slider assembly receiving abone screw 606 and being displaced along a throughhole 608 of thebone plate 602 by a biasingassembly 610 once aspacer 612 of thebone plating system 600 has been removed. Theslider assembly 604 includessliders 604A, 604B, and 604C. Theslider assemblies 604A, 604B are identical to theslider assembly 16 discussed above. However, theslide assembly 604C is different and includes aslide 614 having two throughholes 616 for receiving the two bone screws 606.

Referring to fig. 23, theslider assembly 604C includes aslider 614 and one or more resilient members, such aswires 620, 622. Thewires 620, 622 each haveend portions 624, 626 that extend outwardly from thesides 628, 630 of theslide 614 and engage the through-hole 632 of thebone plate 602.

With reference to fig. 24 and 25, due to the lateral extent of the slidingmember 614, the slidingmember 614 has a curvature that is complementary to the curvature of the outer surface of the bone while minimizing interference with surrounding tissue. In the illustrated embodiment, theslider 614 includes a concavelower surface 634 and a convexupper surface 636. Due to the curvature of theslider 614, thewires 620, 622 have a complex curvature throughout theslider 614. More specifically, referring to fig. 24, theslider 614 includeschannels 640, 642 and thewires 620, 622 extend upwardly and leftwardly (as viewed in fig. 24) into thechannels 640, 642 at theside 628.

Referring to fig. 26,channels 640, 642 each include an outerenlarged portion 650 and a narrowintermediate portion 652. Theslide 614 includes awall 654 extending around each throughhole 616, and thewall 654 includes anangled surface 656,curved corners 658, and anintermediate support surface 660. Theslide 614 includes awall 662 opposite thewall 654 and spanning thechannel 640. As described above with respect to slide 18, the outerenlarged portions 650 ofchannels 640, 642 allow movement of the outerintermediate portions 670 ofwires 620, 622 aswires 620, 622 change from the loaded configuration to the unloaded configuration and outerintermediate portions 670 pivot indirection 674. Thelines 620, 622 include anintermediate portion 680, theintermediate portion 680 including a bend 740 (see fig. 29) out of the page of fig. 26 and an innerintermediate portion 682, the innerintermediate portion 682 connected to the outerintermediate portion 670 by abend 684 generally in the plane of the cross-section taken in fig. 26.

Referring to fig. 27, achannel 642 is shown, and it will be appreciated that thechannel 640 is similar in many respects. More specifically, thechannel 642 includes afirst channel portion 712 extending inwardly from theside 628 and having anaxis 700. Thechannel 642 includes asecond channel portion 714 extending inwardly from theside 630 and having anaxis 702 therein. There is anangle 704 between theaxes 700, 702. Theangle 704 forms a bend 740 (see fig. 29) in themiddle portion 680 of theline 622 to provide sufficient material in thelower wall 706 of theslider 614 and to accommodate the concavelower surface 634. Theslider 614 includes anupper wall 708, theupper wall 708 having a throughopening 710 therein that allows for a line ofsight 622. The throughopening 710 may be formed during manufacture of theslider 614 by a machine tool that enters thechannel 642 from above and machines out material as needed. In other embodiments, the throughopening 710 is not used, for example if theslider 614 is produced using additive manufacturing. Thelower wall 706 includes asloped surface 716 in thefirst channel portion 712 to support one of the innerintermediate portions 682 of thewire 622 and asloped surface 718 in thesecond channel portion 714 to support the other innerintermediate portion 682. Likewise, theupper wall 708 includesinclined surfaces 722, 724 that, together with the lowerinclined surfaces 716, 718, maintain thebend 740 in theintermediate portion 680 whether theline 622 is in its loaded or unloaded configuration.

Referring to fig. 28,line 622 is shown removed from theslide 614 and in its loaded configuration. In the loaded configuration, the outerintermediate portion 670 is angled 730 with respect to the innerintermediate portion 682, and twobends 684 are formed in thewire 622. While fig. 28 is a top plan view and fig. 29 is a rear elevational view ofline 622 in its loaded configuration. As discussed above with respect to fig. 27, the first andsecond channel portions 712, 714 create abend 740 in themiddle portion 680 of thewire 622 to provide clearance for the concavelower surface 634 of theslider 714. Thebend 740 positions the outerintermediate portions 670 at anangle 742 with respect to each other. Thus, when thewires 620, 622 are in the loaded configuration, eachwire 620, 622 has three bends, including twobends 684 and abend 740. Once thespacer 612 has been removed from thebone plate 602 and thepins 620, 622 push theslide 614 to its unloaded position, thebend 684 straightens in a manner similar to the straightening of thebend 295 from fig. 15 to fig. 16. However, even if theslide 614 has been displaced to the unloaded position, thechannels 640, 642 maintain thebend 740 in themiddle portion 680 of thewires 620, 622 because, unlike the outermiddle portion 670, the innermiddle portion 682 is constrained against movement.

Referring to fig. 30,line 622 is shown in side elevation to illustrate how each of thebends 684 orients its outerintermediate portion 670 to extend transverse to the innerintermediate portion 682. In addition, thebend 740 provides a vertical component of the extent of the outerintermediate portion 670 and the innerintermediate portion 672 of the line 622 (as shown in fig. 30). Whenspacer 612 is removed frombone plate 602, outerintermediate portion 670 pivots indirection 674.

Referring to FIG. 31,bone plating system 800 is similar in many respects tobone plating system 10 described above.Bone plate system 800 includes abone plate 802 having a throughopening 804 that receives aslider assembly 806. Theslider assembly 806 includes aslider 808, theslider 808 having a throughhole 810 that receives thebone screw 812. Thebone plating system 800 includes aspacer 814 that is removable from thebone plate 802 to allow theslider assembly 806 to be displaced to an unloaded position, which compresses the bone connected to thebone screw 812. One difference betweenbone plate system 800 andbone plate system 10 described above is thatbone plate 802 has a dog-bone shaped configuration, withbone plate 802 having enlargedend portions 816, 818 and a narrowmiddle portion 820. The narrowmiddle portion 820forms notches 822, 824 on opposite sides of thebone plate 802. Eachend portion 816, 818 includes two throughholes 810 to receive twoslider assemblies 806.

With respect to fig. 32-35, abone plate 900 is provided that is similar in many respects tobone plate 12 described above.Bone plate 900 may be used inbone plate system 10 in place ofbone plate 12. For example, thebone plate 900 includes a throughopening 902 configured to receive theslider assembly 16. Thebone plate 900 includes asidewall 903 having anaperture 904 for receiving an end portion of thewires 20, 22 of theslider assembly 16. With respect to fig. 34 and 35, eachaperture 904 includes anangled surface 906 for supporting the associatedwire 20, 22 and provides for a more gradual bending of thewires 20, 22 when theslide 18 is held in the loaded configuration in the throughopening 902 by thespacer 36. With respect to fig. 33, thebone plate 12 has a thickness that varies between its upper and lower surfaces, including a thinnermiddle portion 910 betweenthicker side portions 912. The thinnermiddle portion 910 may include, for example, a generally concave surface portion. Conversely, thelower surface 914 of thebone plate 900 may have a generally concave surface portion. The thinnermiddle portion 910 provides a reduced thickness along the midline of the plate, which may improve some patients' interaction with surrounding tissue.

While particular embodiments of the present invention have been illustrated and described, it will be understood that numerous changes and modifications may be suggested to one skilled in the art, and it is intended to cover all such changes and modifications as fall within the scope of the appended claims.

Claims (30)

1. A bone plating system, the bone plating system comprising:

a bone plate;

a plurality of elongated through openings of the bone plate, each elongated through opening having a pair of end portions spanning the through opening from one another;

a plurality of bone screws, each bone screw having a head portion and a shaft portion, the shaft portion configured to be driven into bone;

a plurality of sliders located in the elongated through openings and having through holes configured to receive the head portions of the bone screws, the sliders and the head portions of the bone screws received therein being displaceable within the elongated through openings relative to the bone plate;

at least one resilient member for being configured to apply a biasing force to the slider to urge the slider towards one end portion of the respective through opening; and

at least one actuator having an interference position in which the actuator prevents displacement of the slide toward the one end portion of the respective through opening and a clearance position in which the actuator allows the at least one resilient member to urge the slide and the bone screw received therein along and toward the through opening of the rigid bone plate.

2. The bone plating system of claim 1, wherein the at least one actuator in the interference position thereof maintains the at least one resilient member in a loaded configuration and retains each of the slides at opposite end portions of the respective through opening.

3. The bone plating system of claim 1, wherein the at least one resilient member includes a plurality of elongated resilient wires, each elongated resilient wire being associated with one of the slides.

4. The bone plating system of claim 1, wherein the at least one resilient member includes a plurality of elongated resilient members, each elongated resilient member having a pair of opposing end portions and an intermediate portion between the end portions, the intermediate portion being supported by one of the slides and the end portions being supported by the bone plate.

5. The bone plating system of claim 1, wherein the at least one resilient member comprises a plurality of resilient members, each resilient member extending between one of the slides and the bone plate, each resilient member having a deformed configuration including a curved portion when the at least one actuator is in the interference position, the curved portion being allowed to straighten toward its undeformed configuration when the at least one actuator is in the clearance position.

6. The bone plating system of claim 1, wherein the at least one resilient member includes a pair of resilient members secured to each of the slides, each resilient member having a pair of portions connecting the slide to the bone plate.

7. The bone plating system of claim 1, wherein the at least one actuator includes a plurality of actuators, each actuator having a head portion and a body portion, the head portion configured to be engaged by an actuator removal instrument, the body portion being retained between one of the slides and the bone plate when the actuator is in the interference position.

8. The bone plating system of claim 1, wherein the bone plate includes a planar wall portion extending along one of the through openings, and one of the slides includes a planar wall portion facing the planar wall portion of the bone plate; and

the at least one actuator has a pair of flats that engage the flat wall portions of the bone plate and the flat wall portions of the one slide when the actuator is in the interference position.

9. The bone plating system of claim 1, wherein at least one of the slides includes a pair of through holes sized to receive head portions of a pair of bone screws.

10. The bone plating system of claim 1, wherein the bone plate has a unitary, one-piece construction.

11. The bone plating system of claim 1, wherein the slider is rigid and does not deform upon seating of the bone anchor head portion in the through hole of the slider.

12. The bone plating system of claim 1, wherein the at least one resilient member is in a deformed configuration when the at least one actuator is in the interference position and the at least one resilient member applies a biasing force against each of the slides to clamp the at least one actuator between the slides and the bone plate, and the at least one resilient member is displaced toward an undeformed configuration when the at least one actuator is in the clearance position.

13. The bone plating system of claim 1, wherein there is a single slide in each of the elongated through openings of the bone plate.

14. A bone plating system for fixing a pair of bones, the bone plating system comprising:

a bone plate;

a pair of elongated through openings of the bone plate;

a pair of bone screws for securing the bone plate to the pair of bones, each bone screw having a head portion and a shank portion;

a pair of slides located in the elongated through opening of the bone plate, each slide having a through hole configured to allow the shaft portion of one of the bone screws to be driven through the through hole and into bone, and the head portion to be seated in the through hole;

at least one actuator configured to be clamped between the slide and the bone plate;

at least one resilient member configured to apply a biasing force to the slider to urge the slider against the at least one actuator and cause the slider to clamp the at least one actuator between the slider and the bone plate; and

the at least one actuator is removable from being clamped between the sled and the bone plate such that the biasing force urges each sled and the bone screw located therein toward the other sled and bone screw to compress the bones together.

15. The bone plating system of claim 14, wherein the at least one resilient member comprises at least one elongated resilient wire.

16. The bone plating system of claim 15, wherein the at least one elongate elastic wire includes a pair of elongate elastic wires secured to each of the slides, the pair of elongate elastic wires connecting the slide to the bone plate.

17. The bone plating system of claim 14, wherein the at least one resilient member includes at least one bend when the actuator is clamped between the slide and the bone plate, and the at least one bend straightens in response to the at least one actuator being removed from clamping between the slide and the bone plate.

18. The bone plating system of claim 14, wherein the at least one resilient member includes at least one resilient member associated with each of the slides.

19. The bone plating system of claim 18, wherein the at least one resilient member connects the associated slide to the bone plate and supports the slide in the through opening of the bone plate.

20. The bone plating system of claim 18, wherein each slider includes a pair of support surfaces extending transversely to each other, and the at least one resilient member associated with the slider has a loaded configuration in which a portion of the resilient member extends along the support surfaces and an unloaded configuration in which the portion of the resilient member is spaced from the wire support surface.

21. The bone plating system of claim 14, wherein each slide includes opposing sides and at least one channel extending intermediate the sides, the at least one channel being sized to allow the at least one resilient member to extend through the at least one channel.

22. The bone plating system of claim 21, wherein the at least one resilient member has a pair of portions that pivot within the channel in response to the at least one actuator being removed from being clamped between the slider and the bone plate, and the at least one channel includes an enlarged portion at each of the sides that allows pivotal movement of the portions of the resilient member.

23. The bone plating system of claim 21, wherein the at least one channel includes a pair of channels extending intermediate the lateral sides, and the at least one resilient member includes a pair of resilient wires associated with each of the slides extending through the channels.

24. The bone plating system of claim 14, wherein the at least one actuator includes a plurality of actuators, each actuator having a head portion configured to be engaged by an actuator removal instrument and a body portion for clamping between one of the slides and the bone plate and resisting displacement of the slide toward the other slide.

25. The bone plating system of claim 14, wherein the at least one elastic member comprises superelastic nitinol.

26. A method of compressing a pair of bones, the method comprising:

positioning a bone plate against the bone;

driving a shank of a bone screw into a through hole of a slide located in an elongated through opening of the bone plate and into engagement with the bone;

disposing a head portion of the bone screw in the through-hole of the slide;

removing at least one actuator from the bone plate; and

allowing at least one resilient member to urge the sled and a portion of the bone screw head located therein toward each other along the elongated through opening of the bone plate and compress the bone together.

27. The method of claim 26, wherein removing the at least one actuator from the bone plate comprises removing at least a portion of the at least one actuator from between the slider and the bone plate.

28. The method of claim 26, wherein disposing the head portion of the bone screw comprises disposing the head portion of the bone screw in the through hole of the slide without deforming the slide.

29. The method of claim 26, wherein the at least one resilient member comprises a curved elongated resilient member, and allowing the at least one resilient member to urge the sled and the portion of the bone screw head located therein toward each other comprises allowing the curved elongated resilient member to straighten.

30. The method of claim 26, wherein allowing the at least one resilient member to urge the slips together with the bone screw head portions therein includes allowing a resilient member secured to each of the slips to urge the slips toward end portions of the through opening.

Images